There is increasing evidence that the form of low-density lipoprotein (LDL) could play an important role in the severity of acute coronary syndromes. In a study in the 17 April Circulation Shoichi Ehara and colleagues at the Osaka City University Medical School, Japan investigated the type of LDL present in the artherosclerotic plaques of patients having suffered recent coronary episodes.

The first part of the study involved 135 patients with various symptoms and signs of heart attack or angina. In all, a third suffered from a heart attack (studied within 24 hours of the attack), a third from unstable angina and a third from stable angina. These were compared with a control group. Blood samples were taken when the patients were admitted to hospital.

Patients who had a heart attack had average levels of oxidised LDL cholesterol (ox-LDL) of 1.95 ng per 5 μg of LDL protein. This compares with...

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